Health exchanges: What 10 Republican governors have said

Storified by Digital First Media · Wed, Dec 12 2012 14:16:43

A key deadline for the implementation of the 2010 health care overhaul is coming soon. States have until Friday to decide whether to set up their own health-insurance exchanges or else watch the federal government run one for them.

The exchanges will allow consumers and small businesses to comparison shop for health insurance, similar to how travelers can buy plane tickets on sites such as Travelocity.

So far six states led by Democrats — Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington — have been given early approval for their own exchanges.

But many Republican governors, most of whom opposed the 2010 health care law, have said they will not set up their own exchanges. Below, a look at the range of Republican opinions.

“There will be a health insurance exchange in Idaho,” Otter said in a statement. “Our options have come down to this: Do nothing and be at the federal government’s mercy in how that exchange is designed and run, or take a seat at the table and play the cards we’ve been dealt. I cannot willingly surrender a role for Idaho.”

“We are certainly going to go to the president and give him a chance to actually be bipartisan and give him a chance to give us the flexibility to bring more market-based competition and ideas into health care programs, and I hope he’ll work with us to do that,” he said.

Michigan: ‘Must be realistic’

Michigan Gov. Rick Snyder hoped to create a state-run exchange but he was stymied by Republicans in the state House of Representatives, who refused to approve the bill. He’s said he still hopes for a state plan later but may have to move ahead with a federal-run exchange because of the deadline.

“Ensuring that Michigan residents have the best available quality health care and customer service has been a priority from Day One,” he said in a statement. “I have felt strongly that a Michigan-run MI Health Marketplace could further accomplish this goal. That said, we must be realistic about how feasible implementing this could be under the current federal time frames.”

New Jersey: ‘Await federal guidance’

New Jersey Gov. Chris Christie vetoed legislation that would have set up a health insurance exchange, arguing the federal government had not answered key questions.

“New Jersey and all other states still await substantial federal guidance on the functioning of all three types of exchanges,” he said. “To be sure, the decision of whether to move forward with a state-based exchange can only be fully understood when competitively compared to the overall value of the other options.”

Pennsylvania: ‘Haphazard planning’

Pennsylvania Gov. Tom Corbett said he would not set up a system, arguing the Obama administration had not adequately answered questions about cost and other issues.

“Health care reform is too important to be achieved through haphazard planning. Pennsylvania taxpayers and businesses deserve more. They deserve informed decision making and a strong plan that responsibly uses taxpayer dollars.”

Tennessee: ‘A business decision’

Tennessee Gov. Bill Haslam said in a speech Monday that the state will not create a health insurance exchange, arguing he did not have enough information from the federal government on what was required.

“To me, this is a business decision,” he said. “If you take the politics out of the decision, what you’re left with is this: As the CEO of the state of Tennessee I’m being asked to make a significant business decision based on information that’s only now dribbling out of Washington and that we appear to have little influence over.”

Texas: ‘Merely an illusion’

Texas Gov. Rick Perry, who opposed the 2010 health care law during his unsuccessful run for the Republican presidential nomination this year, said the state will not set up its own exchange.

“As long as the federal government has the ability to force unknown mandates and costs upon our citizens, while retaining the sole power in approving what an exchange looks like, the notion of a state exchange is merely an illusion,” he wrote in a letter. “It would not be fiscally responsible to put hard-working Texans on the financial hook for an unknown amount of money to operate a system under rules that have not even been written.”

“I am confident that if you make this change, several other states will join Utah and request certification for state-based exchanges based on our model,” he wrote in a letter. “I am committed to our model, and I will continue to pursue a Utah solution to Utah challenges.”